This document discusses strategies for preventing preeclampsia, including the roles of aspirin and calcium supplementation. It summarizes several studies that have examined the effects of these interventions. The studies found that aspirin reduces the risk of preeclampsia by 17% and the risk of preterm birth by 8%. Calcium supplementation, especially for those with low dietary calcium intake, reduces the risk of preeclampsia by 45% and the risk of preterm birth by 24%. However, the benefits of calcium may depend on preeclampsia risk factors and dietary intake. The document concludes that aspirin and calcium supplementation can help reduce risks, but their effects may vary depending on individual risk profiles.
*I hope its help you all for preparation part 1 exam for MRCOG & MOG and your daily job.Good Luck May ALLAH bless our work and study,Good luck to all.dont forget to pray to ALLAH.if i wrong please correct me..process of learning..
*I hope its help you all for preparation part 1 exam for MRCOG & MOG and your daily job.Good Luck May ALLAH bless our work and study,Good luck to all.dont forget to pray to ALLAH.if i wrong please correct me..process of learning..
MANAGEMENT OF PRETERM PROM ON INDUCTION OF LABOUR Lifecare Centre
INCIDENCE OF PPROM
Preterm PROM-defined as PROM prior to 37 weeks of gestation complicates
2% to 4% of all singleton
7% to 20% of twin pregnancies.
It is the leading identifiable cause of premature birth ( 30%)
accounts for approximately 18% to 20% of perinatal deaths in the United States.
Dr. Sharda Jain
Dr. jyoti Bhasker
Lecture by Dr Sujoy Dasgupta in BOGSCON 2015, the Annual Conference of Bengal Obstetric and Gynaecological Society, held at Hotel Novotel, Kolkata in January, 2015; where he had been invited as FACULTY to deliver his lecture
Prelabour Rupture of Membrane (PROM) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Prelabour Rupture of Membrane (PROM). I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
MANAGEMENT OF PRETERM PROM ON INDUCTION OF LABOUR Lifecare Centre
INCIDENCE OF PPROM
Preterm PROM-defined as PROM prior to 37 weeks of gestation complicates
2% to 4% of all singleton
7% to 20% of twin pregnancies.
It is the leading identifiable cause of premature birth ( 30%)
accounts for approximately 18% to 20% of perinatal deaths in the United States.
Dr. Sharda Jain
Dr. jyoti Bhasker
Lecture by Dr Sujoy Dasgupta in BOGSCON 2015, the Annual Conference of Bengal Obstetric and Gynaecological Society, held at Hotel Novotel, Kolkata in January, 2015; where he had been invited as FACULTY to deliver his lecture
Prelabour Rupture of Membrane (PROM) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Prelabour Rupture of Membrane (PROM). I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Actualización 2008 sobre Preeclampsia a cargo de la En esta clase se presentó una conferencia de gran calidad sobre PREECLAMPSIA y ejemplos sobre preguntas tipo ECAES, a cargo de la DRA. Merly Muñoz Espinosa Residente Gineco – Obstetricia,USCO 2008.
The effect of Metformin on endometrial tumor-regulatory genes and systemic metabolic parameters in polycystic ovarian syndrome – a proof-of-concept study
HYPERTENSION IN PREGNANCY SOGON FINAL ONE.pptAdeniyiAkiseku
Hypertensive disorders are the most common medical complication of pregnancy
It complicates up to 10% of pregnancies
It is a leading cause of maternal and perinatal morbidity and mortality worldwide
Rates are rising because of the older, more obese obstetric population with medical issues
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
2. DEFINITIONS
• Chronic hypertension
• Hypertension (BP ≫
140
90
mmHg; 4 – 6 hours apart); < 20 weeks of gestation
• Gestational hypertension
• Hypertension (BP ≫
140
90
mmHg; 4 – 6 hours apart); > 20 weeks of gestation
• Without significant proteinuria
• Pre – eclampsia
• Hypertension (BP ≫
140
90
mmHg; 4 – 6 hours apart); > 20 weeks of gestation
• With significant proteinuria – urine dipstick 2+ or more; or 24 hours urine protein
300 mg per day or more
3. • Eclampsia
• Seizure associated with pre-eclampsia
• Chronic hypertension with superimposed pre-eclampsia
• Unclassified hypertension
• Hypertension (BP ≫
140
90
mmHg; 4 – 6 hours apart); > 20 weeks of gestation but no
BP record prior to that
Based on ISSHP 2001 (International Society for Study of Hypertension in
Pregnancy)
8. • Fetal/neonatal morbidity/mortality
• 1 in 20 (5%) stillbirths occurred in women with pre-eclampsia
• 8 – 10% of all preterm birth result from hypertensive disorders
• Small for gestational age
9. REDUCING THE RISK OF HYPERTENSIVE
DISORDERS IN PREGNANCY
• Pre-existing risk factors
• Modifiable
• Obesity
• Non-modifiable
• Medical illnesses
• Age
• Primiparity
• Family history
10. ANTIPLATELET AGENTS
• Rational
• Pre-eclampsia is associated with deficient intravascular production of
prostacyclin (a vasodilator) and excessive production of thromboxane – a
vasoconstrictor and stimulant of platelet aggregation
• Antiplatelet agents – might prevent or delay development of pre-eclampsia
• Evidence
• Before CLASP TRIAL
• Small trials of antiplatelet therapy
• Reduction of about three-quarters in the incidence of PE
• Some avoidance of IUGR
12. • Multicentre study
• 9364 women – randomly assigned 60 mg aspirin or matching placebo
• 74% entered for prophylaxis of pre-eclampsia
• 12% for prophylaxis of IUGR
• 3% for treatment of IUGR
• Results
• Use of aspirin was associated with a reduction of only 12% in the incidence of
proteinuric pre-eclampsia (not significant)
• No significant effect on the incidence of IUGR or stillbirth and neonatal death
• Significantly reduce the likelihood of premature delivery (19.7% vs 22,2%;
p=0.004)
13. • Was not associated with a significant increase in placental haemorrhages or
bleeding during epidural anaesthesia
• Safe for the fetus and newborn infant
• Conclusion
• Do not support routine prophylactic or therapeutic administration of antiplatelet
therapy in pregnancy to all women at increased risk of pre-eclampsia or IUGR
• May be justified in women judged to be especially liable to early onset PE severe
enough to need very preterm delivery
14.
15. • All randomised trials comparing antiplatelet agents with either placebo or no
antiplatelet agent were included
• To assess the effectiveness and safety of antiplatelet agents for women at
risk of developing pre-eclampsia
• Participants were pregnant women at risk of developing pre-eclampsia
• Results
• 59 trials (37,560 women) included
• 17% reduction in the risk of pre-eclampsia associated with the use of antiplatelet
agents; RR 0.83; NNT 72
Duley L, Henderson-Smart DJ, Meher S, King JF. Antiplatelet agents for preventing pre-eclampsia
and its complications. Cochrane Database of Systemic Reviews 2007.
16. • Significant increase in the absolute risk reduction of pre-elampsia for high risk
compared with moderate risk women
• 8% reduction in relative risk of preterm birth; NNT 72
• 14% reduction in fetal or neonatal death
• 10% reduction in small-for-gestational age babies
• Conclusion
• Antiplatelet agents have moderate benefits when used for prevention of pre-eclampsia
and its consequences
Duley L, Henderson-Smart DJ, Meher S, King JF. Antiplatelet agents for preventing pre-eclampsia
and its complications. Cochrane Database of Systemic Reviews 2007.
17. RECOMMENDATION
• Advice women at high of pre-eclampsia to take 75 mg of aspirin daily from
12 weeks until birth of baby
• High risk factors (any one of the following)
• Hypertensive disease during a previous pregnancy
• Chronic kidney disease
• Autoimmune disease such as SLE or antiphospholipid syndrome
• Type 1 or 2 DM
• Chronic hypertension
NICE Clinical Guideline; Hypertension in Pregnancy; August 2010 (revised reprint January
2011)
18. • Moderate risk (more than one of the following)
• First pregnancy
• Age 40 year-old
• Pregnancy interval of more than 10 years
• BMI of 35 or more at first visit
• Family history of pre-eclampsia
• Multiple pregnancy
NICE Clinical Guideline; Hypertension in Pregnancy; August 2010 (revised reprint January
2011)
20. • To assess the effects of calcium supplementation during pregnancy on
hypertensive disorders of pregnancy and related maternal and child
outcomes
• Randomised trials comparing at least 1 g daily of calcium during pregnancy
with placebos
• Results
• 13 studies; 15730 women
• The average risk of high blood pressure was reduced with calcium
supplementation (RR 0.65)
• Reduction in the average risk of pre-eclampsia associated with calcium (RR 0.45)
21. • Effect was greatest for women with low baseline calcium intake (RR 0.36) and
those high risk
• Risk of preterm birth reduced (RR 0.76)
• Composite outcome maternal death or serious morbidity was reduced (RR 0.80)
• No overall effect on the risk of stillbirth or death
• Anomalous increase in the risk of HELLP syndrome (RR 2.67)
• Subgroup analysis showed no statistically significant effect of calcium on the
incidence of pre-eclampsia in women with adequate dietary calcium
22. LIMITATION OF
RECOMMENDATION
• Benefits are greatest in women with deficient dietary calcium
• Is it relevant to our population?
• Significance of the effect is influenced by pre-eclampsia risk status
• Greatest benefits for women who are high risk for pre-eclampsia
• Large studies were conducted in women at low risk and small trials were
conducted in women at high risk
• Conclusion
• Although large studies on the use of calcium to prevent hypertensive disorders
have been carried out, the variation in population and calcium status has made
it impossible to reach a conclusion on the value of such treatment
23. OTHER INTERVENTIONS
• Not recommended
• Rest
• Low salt diet
• Exercise in pregnancy
• Weight management in pregnancy
• Other pharmaceutical agents (nitric oxide donors, progesterone, diuretics,
LMWH)
• Nutritional supplements (Mg, Folic acid, antioxidants, garlic)
